Antimicrobial prescribing in older adults.

Infectious diseases pose a significant threat to older adult health and well-being. Determining the appropriate use and selection of antimicrobials in older adults can be challenging. Age-related physiologic changes, multiple comorbidities, and polypharmacy are factors that can make prescribing antimicrobials complicated and the effectiveness of therapy unpredictable.

Resident strategies for making a life in a nursing home: a qualitative study.

AIM: To identify strategies that older adults use to adapt to live in long-term care. BACKGROUND: The use of long-term care services has risen and this trend is expected to continue as the population reaches old age. Moving into a long-term care setting has been documented internationally as an overwhelming life change for many older adults. It has been observed that residents adjust differently over time, but the basis for these differences needs further exploration. DESIGN: A qualitative design using grounded theory method was employed. METHODS: A total of in-depth interviews were conducted in October 2008-February 2009 with a sample of 21 participants. Participants ranged in age from 65-93 years, 81% women and 19% men; mainly Caucasian with one African American and one Hispanic. Length of stay ranged from 3 days to over 9 years living in long-term care so that all stages of adjustment were included in the study. Ground theory method was used to analyse the data. FINDINGS: The results of this study yielded 21 facilitative strategies. The core category identified was personal resiliency, which served as the underpinning for the strategies used by the participants. Strategies were identified in making the decision to move into long-term care and in day-to-day living. CONCLUSION: Understanding the strategies that facilitate residents to make a successful transition to long-term care life will assist nurses to intervene in ways that are supportive. The strategies identified in this study may be used to develop interventions for residents that are having difficulty living in long-term care. Further exploration of how resiliency has an impact on strategies used by residents is clinically relevant, but further research is needed.

Making the transition to nursing home life: a framework to help older adults adapt to the long-term care environment.

This integrated literature review presents the state of nursing science regarding older adults' perspectives on postadmission transition and adaptation to the nursing home. Transition, adaptation, and nursing home were key terms used to search electronic databases. A total of 27 articles were reviewed; 13 articles met the inclusion criteria. Themes and findings were identified for each of the studies and placed into two categories: theoretical framework development and application of existing theoretical frameworks. A comprehensive transition process model is offered.